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General NPI Number Information
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NPI Number | 1255082830
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Entity Type | Organization
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Legal Business Name | JASON WATSON GRANEY D C
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 4690 NEBO DR
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City | LA MESA
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State | CA
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Zip | 91941-5233
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Country | US
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Telephone | 619-460-2224
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Fax | 619-460-2226
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Provider Business Mailing Address
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Address Line | 4690 NEBO DR
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City | LA MESA
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State | CA
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Zip | 91941-5233
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Country | US
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Telephone | 619-460-2224
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Fax | 619-460-2226
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Authorized Official
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Title or Position | OWNER
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Name | JASON W GRANEY
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Credential |
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Telephone | 619-460-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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